From Our Foreign Correspondent: Bus 237 to Pokhara.

A Remarkable Success Story in the Nile Delta An invitation to visit Mansoura University to view their ?caI progress and to give four lectures was accepted w'th enthusiasm and considerable interest, though with ?ome reservations as my wife was reluctant to leave Bristol where two new granddaughters had recently arnved. The Department of Urology and Nephrology at Mansoura had already been recognised in Egypt as one ?f the leading centres for this specialty by the award ?'9ht years ago of one of the first gold medals of the ^gyptian Urological Association to our colleague and ^rmer Registrar at Southmead Hospital, Professor Mohamed Ghoneim. It was Mohamed who had arranged *he invitation and I fully anticipated finding a high standard of work. I was agreeably surprised to find a very high quality of equipment and other facilities despite the sad state of the economy in Egypt. In fact the Department I Provided such an oasis of excellence it is worthy of a special report. The Urology and Nephrology Department occupies a ^ew and architecturally designed building within the University campus, elegantly landscaped and situated adjacent to the main University Hospital so that although ^ministered as an independent unit it is not isolated r?rn other specialties, or from the Department of General Surgery and General Medicine. The Department consists of a teaching and administrative unit, a hospital of '20 beds, a residency and, adjacent to the Department, here are full research facilities occupying three floors ^'th a large animal house on the ground floor. A suite of hree operating theatres and an endoscopy room with w'n tables is used to full capacity five days a week. I was driven up an impressive ramp to the entrance of I .he teaching hospital, where I was received by Mohamed |n a splendid foyer artistically designed around an essen'allV functional layout. The next floor was approached V a neat staircase curving round a small, well tended , lr|door garden. Mohamed's room was at the end of the I corridor where it gave an immediate impression of e"icient organisation and attention to detail as well as scrupulous cleanliness, yet at the same time a comfort-

zling batter over camp-fires, to be washed down with dirty glassfuls of warm white curds.Scattered heaps of garbage and the occasional dead dog add a touch of local colour, or its olfactory equivalent.
After wandering through a thick haze of dust, exhaust fumes, and wood-smoke, I eventually found a row of ticket-booths, each with its destination-board labelled in Nepali script.Even years of deciphering the hieroglyphics of my clinical assis- tants did not enable me to identify one that said Pokhara, and I had to stumble along like a blind beggar shouting 'Pokhara?Pokhara?' until some kind soul led me to the right queue.Finding the right bus was even trickier, since my ticket simply said 'Bus 237, seat 47'.More helpless pantomime and at length a ragged barefoot urchin grabbed my ticket, led me through the maze of buses to No. 237, marched me down the aisle and with a proud proprietorial flour- ish showed me seat 47, which was to be my home for the next 10 hours.
My guide, who looked about 8 years old and smoked like a chimney, had clearly never captured a European of any size before, and until our departure he kept returning at intervals to exhibit me to small parties of his friends.
Over the next half hour the bus slowly filled up with large numbers of the Nepalese lower orders, and when it was full to capacity, about 30 more were squeezed in, and we were off.
Buses in Nepal are built, reason- ably enough, to accommodate the Nepalese, who are congenitally small, and are further stunted by a life-time of malnutrition.
Being 6ft.4in.tall, the length of my femur exceeded the distance between the seats.This proved uncomfortable at first, and became excruciating later.The roof was correspondingly low, so that whenever we went over a pothole at speed, which was fre- quently, the entire company rose as one, but mine was the only head to strike the roof with any force.My travelling companions spoke little English, but were clearly sympathe- tic to my plight.
The neighbour on my right turned out to be a gaine (pronounced 'gynae', as in obstetrics), a profes- sional beggar-musician who carried    Campylobacter sandwiches sold here a 3-stringed fiddle crudely carved from a single block of wood.'Gynaes' eke out a precarious living in rural Nepal by travelling from vil- lage to village like medieval trouba- dors.My 'gynae' friend, noting my interest in his fiddle and sensing business, played me a charming little Nepalese melody, accompanied by a pleasantly plaintive song.Encour- aged by my response, he went into an encore which to my amazement was recognizable as 'Frere Jacques'.The tune was fairly accurate, but my God, the poor lyrics!After that I wouldn't have been surprised if he'd tackled Bach's Toccata and Fugue in D Minor, but he obviously realised he'd exhausted my supply of small change.He was an attractive little fellow, but I have to report with re- gret that he played a lot better than he smelt.
The Nepalese landscape resem- bles the pleats of a piano-accordion on a gigantic scale.The bus would grind its way laboriously up huge hillsides, negotiating 20 or 30 hairpin bends on the ascent, then teeter at the top of the pass before plunging down the opposite side with reckless abandon.The windows were small, but between the heads of the other passengers I caught occasional glimpses of Arcadian vistas?terraced fields of vivid green, stark stony hillsides, ricketty bridges over great gorges, small banana plantations, women pounding their washing on smooth rocks in the riv- er, children leading large white bul- locks, distant snowy peaks, and groups of animated girls, their gaudy saris sparkling in the sunshine.
Inside the bus, however, things were less idyllic.The atmosphere be- came steadily more oppressive, the discomfort in my cramped limbs in- creased, and about 4 hours out of Kathmandu I began seriously to re- gret drinking so much coffee for breakfast.Fortunately my need was not unique and eventually the bus stopped in a deserted spot and most of the passengers alighted.My 'gynae' friend made a gesture as though he was brushing crumbs from his lap, and made a noise which should have been 'Wee-wee', but sounded more like 'Ffff-fff'.Much more onomatopoeic, I thought.None of us attempted to hide behind rocks, though most of us did face away from the bus, but since some of the men were squatting with bare but- tocks, it seemed debatable whether this was in fact the most discreet and socially acceptable orientation.The ladies assumed thoughtful express- ions as they crouched demurely in a genteel group some 15 yards down the road.I began to realize why Victorian lady travellers, experienced in the ways of the Orient, used to wear long skirts and no knickers.Nepalese ladies in general, being mainly Hindu or Buddhist, are de- lightfully free from the tiresome over- modesty which can be so dangerous to the male traveller in some Moslem countries.Throughout the journey, as they pushed their way in and out of the over-crowded bus, ladies of all ages squashed various parts of their anatomy into me with no sign of bashfulness other than a disarming giggle.My 'gynae' friend's wife was even less afflicted by the claims of modesty.She clearly suffered from a mobile source of cutaneous irritation and at one stage, following a particularly prolonged bout of scratching, she hoicked up the top part of her dress to expose her generous bosom, and proceeded to conduct a close inspection of the left nipple for the offending parasite.I tactfully averted my gaze, but my 'gynae' friend merely smiled and shook his head tolerantly.
In due course we reached a small market-town, where excited vendors pushed various small items of food through the windows in exchange for exceedingly grubby notes of small denomination.
My gynae friend ate one boiled egg, a small quantity of cooked peas in a twist of paper, and about 5 peanuts.This was all he ate during the 10 hour journey, and his nutritional state suggested that this was his normal caloric intake for the day, if his audience had been generous.
As the hot afternoon wore on, my gynae friend had to turn his attention to his wife, who was leaning for- ward, clutching her head and moan- ing quietly.He was very sweet and supportive, cradling her in his arms and crooning a lullaby to her.As time went by the bus became even hotter, smellier and bumpier, and the moaning became more piteous.My own gastric quietude was already discombobulated by the universal Nepalese habit of noisy hawking and spitting, which was in no way inhi- bited by close confinement in a crowded bus.The ladies did have the grace to lean forward, lift their skirts and aim for the floor between their feet, but the men were less punctilious.They also added variety by blowing their noses out of the win- dows.My diaphragmatic self-control was just about adequate, provided I closed my eyes, clenched my teeth and breathed deeply until the noise abated.This was more than could be said for my 'gynae' friends' wife, who after a slow crescendo of moan- ing, leaned carefully over her hus- band's knee and vomited.Very little went on my shoe.
My earnest prayer for release from this hellish sardine-can was soon answered.The bus coughed, spluttered, groaned and stopped.Once in the fresh air, my relief gradually changed to concern, for we'd passed no garage since leaving Kathmandu 7 hours previously.There was, however, in the universal catch- phrase of the Indian sub-continent, 'No problem'.Rocks were wedged behind the wheels, tools miraculous- (continued on page 144) Figure 3 Temple at Bhaktapur with animal rights Figure 3 Temple at Bhaktapur with animal rights Figure 4 Swayambhu Temple, Kathmandu The all-seeing eyes of Buddha Swayambhu Temple, Kathmandu The all-seeing eyes of Buddha Foreign Correspondent, (continued from page 140) ly appeared, several men dis- appeared under the engine, and after much banging and cursing, bits of bus innards were passed out to the 'pathologist' who read the entrails and predicted a delay of about 25 minutes.This prognosis proved re- markably accurate, and I later learned that one breakdown per journey is about par for the course.
When we eventually reached Pokhara it was dark.My gynae friend and his wife each shouldered huge bundles and cheerfully set off along the track to their own village, which was a further two days march away.As I alighted I was jostled by several small boys shouting 'Come with me sah, this my card, sah, very clean hotel sah, very cheap, follow me'.
Feeling opulent, I plumped for the most expensive, at ?3 per night.This turned out to be a civilized little guest house, which even had toilet paper.
My sense of having endured an epic adventure began to diminish, and it was withered completely by the first guest I spoke to?a Danish girl who had just walked across Tibet.

Figure 1
Figure 1 Sunrise over Annapurna from Pokhara

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Figure 1 Sunrise over Annapurna from Pokhara Figure 2Campylobacter sandwiches sold here